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Individual

DR. WANDA COSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
125 S 9TH ST, PHILADELPHIA, PA 19107-5125
(215) 592-4500
Mailing address
125 S 9TH ST, PHILADELPHIA, PA 19107-5125
(215) 592-4500

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD441753
PA
208D00000X
General Practice Physician
Primary
MD441753
PA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
09/29/2009
Last updated
01/22/2021
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